| NPI | 1245613009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER GODFREY Director 801-479-7035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2020-06-26 |